European Psychiatry - Volume 41 - April 2017

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S256 25th European Congress of Psychiatry / European Psychiatry 41S (2017) S238–S302
EW0439
The Situational Dysphoria Scale
(SITDS): development and validation
of a self-report questionnaire for
assessing situational dysphoria in
borderline patients
A. D’Agostino ∗, A. Aportone , M. Rossi Monti , V. Starcevic
1 University of Urbino Italy, Humanistic Studies, Urbino, Italy
2 University of Sydney, Discipline of Psychiatry- Sydney Medical
School, Sydney, Australia
∗ Corresponding author.
Introduction According to contemporary phenomenological lit-
erature, dysphoria is the background mood characterizing patients
with borderline personality disorders (BPD). In particular circum-
stances, it can take the form of a state of pressure, urge to act, and
quasi-explosion, which is very dependent on situational triggers.
There are currently no instruments able to measure this situational
form of dysphoria.
Objectives To develop and analyze psychometric properties of
the Situational Dysphoria Scale (SITDS), a self-report questionnaire
that measures situational dysphoria.
Aims To validate the SITDS for a future use in routine clinical
practice and, more generally, to assess different forms of dysphoria
in BPD in a more precise way.
Methods The preliminary 58-item SITDS was administered to
105 BPD patients, along with other conceptually similar (Nepean
Dysphoria Scale) and conceptually distinct (Cynical Distrust Scale,
Inventory of Interpersonal Problems-47, empathy quotient, and
borderline personality severity Index-IV) instruments. The psycho-
metric characteristics (reliability, internal structure, convergent
and divergent validity) of the SITDS were then examined.
Results The final 24-item SITDS (with each item rated on three
subscales: internal pressure, urge to act, and quasi-explosion)
demonstrated excellent internal consistency (alpha = .91). A three-
cluster solution was found, with clusters pertaining to personal
events, interpersonal events, and environmental events. There
were medium to strong correlations with NDS, and weaker but still
significant correlations with CynDis, IIP-47, EQ, and BPDSI-IV.
Conclusions The SITDS is a useful and easy-to-handle instrument
for measuring situational dysphoria. Further research in clinical
samples is needed.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW0440
Are patients with emotionally
unstable personality disorder
overmedicated?
E. Dobrzynska
Cygnet Health Care, Cygnet Hospital Kewstoke, Weston-super-Mare,
United Kingdom
Emotionally Unstable Personality Disorder (EUPD) is often consid-
ered as treatment resistant clinical challenge. While effectiveness
of psychological therapies for EUPD is widely acknowledged, there
is less supportive evidence for pharmacotherapy use and patients
with EUPD are perceived as overmedicated.
Objectives and aims The purpose of the study was to review pre-
scribing guidelines and clinical practices for EUPD.
Methods MEDLINE and PsycINFO were searched for all English-
language articles published 2000-2016 and containing the
keywords “emotionally unstable personality disorder”, “borderline
personality disorder”, “pharmacotherapy”, “drug treatment” and
“treatment guidelines”.
Results NICE guidelines (2009) recommend pharmacotherapy
should not be used for EUPD but for comorbid conditions only. In
line with the American Psychiatric Association practice guideline,
the Dutch and German guidelines recommend antipsychotics for
cognitive-perceptual symptoms. However, in contrary tomood sta-
bilisers they question the efficacy of antidepressants on impulsivity
and affective dysregulation.
Studies on clinical practice showed 68% of borderline patients
without comorbid disorder in UK were using antidepressants,
59% antipsychotics, 59% sedatives and 23% mood stabilizers. Sim-
ilar results reported Paolini et al with polypharmacy in 83.5% of
cases.
Conclusions All international guidelines recommend psycholog-
ical therapies as the first-choice in EUPD treatment but diverge
with respect to pharmacotherapy use. NICE and Australian guide-
lines abstain frompsychotropics what may prevent to some degree
counterproductive polypharmacy, but also can refrain from tem-
porary pharmacological support when needed. More RCTs for
pharmacotherapy use in EUPD are needed but meanwhile using
pharmacotherapeutic algorithms for specific symptom domains
might be the way forward.
Disclosure of interest The author has not supplied his/her decla-
ration of competing interest.
EW0441
The purpose of this research was
standardizing the questionnaire of
personality disorder cluster A
N. Farrokhi ∗, S. Ghahari
1 Young reseachers club Of Islamic Azad University - Roudehen
Branch, Clinical Psychology, Tehran, Iran
2 Assistant professor of Mental Health- Iran University of Medical
Sciences IUMS. Center of Excellence in psychiatry- School of
Behavioral Sciences and Mental Health-, clinical psychology, Tehran,
Iran
∗ Corresponding author.
Introduction As more or less stable personality traits of the per-
son, temperament, intellect and body is what makes an individual
unique compatibility with the environment.
Objective The purpose of this research was standardizing the
questionnaire of personality disorder cluster A. On the basis of
realizing criterion standard, DSM- 5.
Method 1303 people from universities of Tehran and Alborz
provinces (753 females and 550 males) were examined by using
the randomized sampling method. The questions of the ques-
tionnaire were conformed Dr. ShahramVaziri on the basis of
Iran s population and culture. Then the reliability was tested
and accomplished simultaneously Millon(MCMI-III) question-
naire.
Result After computing the correlation scales of Millon test with
each of the questions, 20 questions that showed the highest cor-
relation and diagnosis coefficient were chosen and scored again in
next stage.
Conclusions Investigating the psychometric component of three
scales (Paranoid 60%, Schizoid 66%, Schizotypal 59%) shows that
they are reliable and defensibly valid. It can be said that questions
related to all three measures paranoid, schizoid and schizo-
typal of acceptable psychometric properties and reliability are
desirable.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.